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Carmagnola D, Pispero A, Pellegrini G, Sutera S, Henin D, Lodi G, Achilli A, Dellavia C. Maxillary sinus lift augmentation: A randomized clinical trial with histological data comparing deproteinized bovine bone grafting vs graftless procedure with a 5-12-year follow-up. Clin Implant Dent Relat Res 2024; 26:972-985. [PMID: 38979855 DOI: 10.1111/cid.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/30/2024] [Accepted: 06/18/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Different protocols and procedures for sinus lift and implant placement are available, generally involving the use of grafts to increase the tissue volume and/or prevent the Schneiderian membrane from collapsing. Among xenografts, deproteinised bovine bone graft (DBBP) is frequently used in sinus lift procedures. Leaving an ungrafted space following membrane elevation has proven to have a bony regenerative potential as well. This study aimed to compare the clinical and histological features of sinus lift surgery performed with or without biomaterials. METHODS Patients with severe maxillary posterior atrophy (residual bone height 2-6 mm and residual crest thickness ≥4 mm), and in need of sinus lift surgery to allow the placement of three implants were enrolled and randomly divided into two groups. They underwent sinus lifts with DBBP (control) or with a graftless technique (test) and immediate placement of two implants (a mesial and distal one). After 6 months, a bone sample was retrieved from the area between the previously inserted fixtures, and a third, central implant was placed. The collected bone samples were analyzed morphologically and histomorphometrically. The patients were provided with prosthetic restorations after 6 months and followed up for 5-12 years. RESULTS Ten patients were enrolled in the test and nine in the control group. The 6-month follow-up showed in the control group an average augmentation of 10.31 mm (±2.12), while in the test group it was 8.5 mm (±1.41) and a success rate of 96.3% in the control and 86.7% in the test group (p > 0.05). The histological analysis evidenced the presence of new bone tissue surrounded by immature osteoid matrix in the test group, and a variable number of DBBP particles surrounded by an immature woven bone matrix in the control group. CONCLUSION The results of the present trial indicate that, with residual bone height of 2-6 mm and residual crest thickness ≥4 mm, sinus lift surgery with or without biomaterials followed by implant restoration, produces similar clinical and histological outcomes.
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Affiliation(s)
- Daniela Carmagnola
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Alberto Pispero
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Gaia Pellegrini
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Samuele Sutera
- Oral Medicine and Oral Oncology Unit, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Dolaji Henin
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
| | | | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Science, Università degli Studi di Milano, Milan, Italy
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Tao B, Xu J, Gao J, He S, Jiang S, Wang F, Chen X, Wu Y. Deep learning-based automatic segmentation of bone graft material after maxillary sinus augmentation. Clin Oral Implants Res 2024; 35:964-972. [PMID: 38033189 DOI: 10.1111/clr.14221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES To investigate the accuracy and reliability of deep learning in automatic graft material segmentation after maxillary sinus augmentation (SA) from cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS One hundred paired CBCT scans (a preoperative scan and a postoperative scan) were collected and randomly allocated to training (n = 82) and testing (n = 18) subsets. The ground truths of graft materials were labeled by three observers together (two experienced surgeons and a computer engineer). A deep learning model including a 3D V-Net and a 3D Attention V-Net was developed. The overall performance of the model was assessed through the testing data set. The comparative accuracy and inference time consumption of the model-driven and manual segmentation (by two surgeons with 3 years of experience in dental implant surgery) were conducted on 10 CBCT scans from the test samples. RESULTS The deep learning model had a Dice coefficient (Dice) of 90.36 ± 2.53%, a 95% Hausdorff distance (HD) of 1.59 ± 0.82 mm, and an average surface distance (ASD) of 0.38 ± 0.11 mm. The proposed model only needed 7.2 s, while the surgeon took 19.15 min on average to complete a segmentation task. The overall performances of the model were significantly superior to those of surgeons. CONCLUSIONS The proposed deep learning model yielded a more accurate and efficient performance of automatic segmentation of graft material after SA than that of the two surgeons. The proposed model could facilitate a powerful system for volumetric change evaluation, dental implant planning, and digital dentistry.
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Affiliation(s)
- Baoxin Tao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jiangchang Xu
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Gao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Shamin He
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Shuanglin Jiang
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Wang
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yiqun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
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Qian Y, Zhao Y, Lu Y, Bao S, Zhu W, Chen Q, Si M. Clinical and radiographic outcomes of lateral sinus floor elevation with simultaneous hydrophilic implants placement: A retrospective study of 2-5 years. Clin Oral Implants Res 2024; 35:534-546. [PMID: 38366692 DOI: 10.1111/clr.14249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/13/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
AIMS To investigate the clinical and radiographic outcomes of a chemically modified sandblasted large-grit acid-etched implant (hydrophilic) in lateral sinus floor elevation (LSFE), compared with a conventional one (hydrophobic). MATERIALS AND METHODS A retrospective study design was adopted. Patients who received LSFE with simultaneous implant placement were recruited. According to different types of implant surfaces, patients were divided into two groups (the hydrophilic group and the hydrophobic group). Implant survival rate (SR), endo-sinus bone stability on the radiographs, mean probing depths, percentage of bleeding on probing, marginal bone loss, and patient satisfaction were evaluated. RESULTS A total of 106 patients with 180 implants (hydrophilic:101, hydrophobic:79) in 119 maxillary sinuses were included. The follow-up period ranged from 2 to 5 years. Three hydrophobic implants and one hydrophilic implant in four different patients failed. The SR of the hydrophilic group was higher than that of the hydrophobic group but without a significant difference (p > .05). The change and change rate of endo-sinus bone height (ΔESBH and RΔESBH) and bone volume (ΔESBV and RΔESBV) in the hydrophilic group were less than those in the hydrophobic group, with a significant difference at 6 months after implantation. No other significant difference was found between the two groups. CONCLUSION Within the limitations of this study, both hydrophilic and hydrophobic implants were suitable for LSFE with predictable clinical outcomes. Meanwhile, hydrophilic implants could contribute to the grafted endo-sinus bone stability during healing time.
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Affiliation(s)
- Yinjie Qian
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yuxin Zhao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yifan Lu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Siqi Bao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Weijun Zhu
- The First People's Hospital of Yuhang District, Hangzhou, China
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Misi Si
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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Takafuji K, Oyamada Y, Hatakeyama W, Kihara H, Shimazaki N, Fukutoku A, Satoh H, Kondo H. Quantitative analysis of change in bone volume 5 years after sinus floor elevation using plate-shaped bone substitutes: a prospective observational study. Int J Implant Dent 2024; 10:9. [PMID: 38372934 PMCID: PMC10876503 DOI: 10.1186/s40729-023-00501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 09/09/2023] [Indexed: 02/20/2024] Open
Abstract
PURPOSE Tricalcium phosphate (TCP) has osteoconductive ability and reportedly offers similar clinical results as autogenous bone grafts in dental implant treatment. However, few reports quantify temporal changes in augmented bone volume after sinus augmentation. We aimed to establish a three-dimensional (3D) quantification method to assess bone volume after sinus augmentation and to evaluate biocompatibility of the TCP plate. METHODS Maxillary sinus floor augmentation was performed employing the lateral window technique, and plate-shaped β-TCP (TCP plate) was used instead of granular bone grafting materials. After lifting the sinus membrane, the TCP plate was inserted and supported by dental implants or micro-screws. The changes in bone volumes in the maxillary sinus before and after surgery were recorded using cone-beam computed tomography, saved as Digital Imaging and Communications in Medicine-formatted files, and transformed to Standard Triangle Language (STL)-formatted files. Pre- and post-operative STL data of bone volume were superimposed, and the augmented bone volume was calculated. Moreover, changes in bone volumes, TCP plate resorption rates, and bone heights surrounding the implants were three dimensionally quantified. RESULTS Fifteen implants in nine subjects were included in this study. TCP plates secured long-term space making, with results similar to those of granular bone substitutes. Newly formed bone was identified around the implant without bone graft material. TCP plate was absorbed and gradually disappeared. CONCLUSIONS A novel 3D quantification method was established to evaluate changes in bone volume. Clinical application of TCP plate in sinus augmentation could be a better procedure in terms of prognosis and safety.
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Affiliation(s)
- Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan
| | - Yutaro Oyamada
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Nobuko Shimazaki
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Akihiro Fukutoku
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hiroaki Satoh
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan.
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Guruprasad M, Kulloli A, Mehta V, Fiorillo L, Cicciu M. Maxillary Sinus Floor Augmentation With Allograft Alone Compared With Alternate Grafting Materials: A Systematic Review and Meta-Analysis. J Craniofac Surg 2023:00001665-990000000-01243. [PMID: 37991404 DOI: 10.1097/scs.0000000000009913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/29/2023] [Indexed: 11/23/2023] Open
Abstract
A meta-analysis of scientific literature was conducted to ascertain the superiority between allografts and other regenerative grafts for maxillary sinus floor augmentation (MSFA). Review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and registered in PROSPERO-CRD42023392766. Electronic databases like PubMed, Google scholar and Ebsco Host were searched from 2000 to December 2022 for studies reporting MSFA using allografts or other regenerative grafts. Quality assessment of included studies was evaluated using the Cochrane risk of bias (ROB)-2 tool for randomized controlled trials through its domains. Risk of bias summary graph and ROB summary applicability concern were plotted using RevMan software version 5.3. The standardized mean difference was used as a summary statistic measure with random effect model and P value <0.05 as statistically significant. Four studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which all 4 studies were suitable for meta-analysis. Pooled estimate through standardized mean difference signifies that new bone formation was more or less similar for both graft materials, whereas regenerative grafts showed more residual bone grafts (P>0.05). Publication bias through funnel plot showed symmetric distribution with the absence of systematic heterogeneity. Both allografts and other regenerative grafts are equally effective in the MSFA in terms of new bone formation, whereras regenerative grafts showed more residual bone grafts. Furthermore, randomized controlled trials are required to establish evidence in outcomes involving sinus floor augmentation and different graft materials.
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Affiliation(s)
| | | | - Vini Mehta
- Department of Dental Research Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - Luca Fiorillo
- Department of Dental Research Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples
| | - Marco Cicciu
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
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Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures. Diagnostics (Basel) 2023; 13:1684. [PMID: 37238169 PMCID: PMC10217207 DOI: 10.3390/diagnostics13101684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.
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Affiliation(s)
- Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia
| | - Simone Cortellini
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven, 3000 Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Michael M. Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, 141 04 Huddinge, Sweden
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Omori Y, Nakajima Y, Imai H, Yonezawa D, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of Anatomical Parameters on the Dimensions of the Subantral Space and Sinus Mucosa Thickening after Sinus Floor Elevation. A Retrospective Cone Beam Computed Tomography Study. Dent J (Basel) 2021; 9:dj9070076. [PMID: 34202457 PMCID: PMC8304157 DOI: 10.3390/dj9070076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Various anatomical parameters might influence the surgical approach for maxillary sinus floor elevation. The objective of the present study was to retrospectively evaluate the influence of anatomical parameters on the dimensions of the subantral space and of the sinus mucosa thickening after sinus floor elevation. MATERIAL AND METHODS Seventy-eight maxillary sinuses in sixty-five patients were evaluated on cone beam computed tomographies taken before surgery and after one week (t1w) and nine months (t9m). Several parameters such as the distance XF between an axis parallel to the base of the nose (X-axes) and the sinus floor (F) were correlated with the height gain (IF) at t1w and t9m and the post-surgical edema. RESULTS A weak significant positive correlation was observed between height gain vs. sinus height of interest (XF), the balcony, and the sinus floor angle. The post-surgical edema was influenced by the initial mucosa thickness and the xenograft used. CONCLUSIONS Various parameters might affect height gain and sinus mucosa thickening after sinus floor elevation. The height of interest, the balcony, and the sinus floor angle showed significant correlations with height gain. The initial thickness of the mucosa and the biomaterial used influenced the post-surgical edema.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Hideki Imai
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Daichi Yonezawa
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan
- Correspondence:
| | - Mauro Ferri
- ARDEC Foundation, 130001 Cartagena de Indias, Colombia;
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Clinical Outcome of Dental Implants after Maxillary Sinus Augmentation with and without Bone Grafting: A Retrospective Evaluation. MATERIALS 2021; 14:ma14102479. [PMID: 34064784 PMCID: PMC8151007 DOI: 10.3390/ma14102479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 12/21/2022]
Abstract
(1) Background: The purpose of the present study was to retrospectively evaluate and compare the outcome of two sinus augmentation grafting protocols using a xenograft or blood clot alone over a 72-month follow-up. (2) Methods: Patients who received simultaneous lateral sinus floor augmentation and implant placement were included. Subjects were divided into two groups according to the grafting material, namely xenograft or blood clot, and into sub-groups based on the residual alveolar bone height (RABH) below the maxillary sinus, namely 4 to 6 mm or >6 mm. Kaplan-Meier survival estimates were calculated for each material group and for each sub-group at 1, 3, and 6 years. (3) Results: In total, 289 implants inserted in 136 patients with a one-stage procedure were considered. A total of 35 failures were registered. Overall survival rates were 94.2% for xenograft and 85.9% for blood clot alone at 1 year, 91.1% and 81.6% at 3 years, and 91.1% and 78.7% at 6 years. (4) Conclusions: In patients with 4-6 mm RABH, graftless interventions exploiting blood clot alone were not as successful as those using xenograft. When the RABH is low, sinus floor augmentation associated with grafting materials should be preferred whenever possible.
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GOYUSHOV S, DURSUN E, ORHAN K, TÖZÜM T. Three-Dimensional Calculation of Sinus Augmentation Volume after Maxillary Sinus Floor Elevation. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.858177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Starch-Jensen T, Deluiz D, Vitenson J, Bruun NH, Tinoco EMB. Maxillary Sinus Floor Augmentation with Autogenous Bone Graft Compared with a Composite Grafting Material or Bone Substitute Alone: a Systematic Review and Meta-Analysis Assessing Volumetric Stability of the Grafting Material. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2021; 12:e1. [PMID: 33959236 PMCID: PMC8085675 DOI: 10.5037/jomr.2021.12101] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022]
Abstract
Objectives Test the hypothesis of no difference in the volumetric stability of the grafting material following maxillary sinus floor augmentation with autogenous bone graft compared with composite grafting material or bone substitute alone applying the lateral window technique. Material and Methods MEDLINE (PubMed), Embase, Cochrane library and hand-search of relevant journals were conducted. Human studies published in English until the 9th of October 2020 were included. Outcome measures included three-dimensional volumetric changes of the grafting material and potential predictive parameters. Volumetric changes were evaluated by descriptive statistics and meta-analysis including 95% confidence interval. Results Electronic search and hand-searching resulted in 102 entries. Four randomized controlled trials with unclear risk of bias fulfilled the inclusion criteria. The volumetric stability of the grafting material was significantly improved by mixing autogenous bone graft with a non-resorbable xenograft compared with autogenous bone graft. Meta-analyses assessing absolute and relative volumetric changes demonstrated no significant differences between autogenous bone graft compared with allogeneic bone graft, synthetic biomaterials combined with autogenous bone graft or used alone. Association between volumetric changes of the grafting material and potential predictive parameters were not assessed in the included studies. Conclusions Volumetric reduction of the augmented area seems inevitable following maxillary sinus floor augmentation regardless of the grafting material. The volumetric stability of autogenous bone graft is improved with addition of xenograft compared with autogenous bone graft. However, conclusions drawn from this systematic review should be interpreted with caution since only four studies using three-dimensional radiographic measurements were included.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Daniel Deluiz
- Department of Periodontology, Rio de Janeiro State University, Rio de JaneiroBrazil
| | - Julie Vitenson
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, AalborgDenmark
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Chaushu L, Silva ER, Balan VF, Chaushu G, Xavier SP. Sinus augmentation - autograft vs. fresh frozen allograft: Bone density dynamics and implant stability. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:467-471. [PMID: 33007492 DOI: 10.1016/j.jormas.2020.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Compare bone density changes and initial implant stability following sinus augmentation with autogenous bone (AB) vs. fresh frozen bone (FFB). MATERIALS AND METHODS Randomized, prospective, split mouth study. Sinus augmentation executed using either AB or FFB. Dental implants were inserted after 6 months of healing. Implant dimensions and insertion torques were recorded. Prostheses were delivered 6 months thereafter. All patients had computerized tomography (CT) scans 1 week (T1) and 6 months (T2) after initial bone grafting. Third CT (T3) was taken 12 months after prosthesis delivery. Data from CT scans was used to analyze bone density at each period. RESULTS A total of 15 patients (8 males, 7 females) following bilateral sinus augmentation procedures, were included. Mean age was 54 ± 5 years (range 48-60 years). All patients had 3 CT examinations. The initial augmented AB density was higher than the initial FFB density. Nevertheless, density differences between the two groups were not statistically significant at any time frame. At T2 density of both grafts showed a statistically significant increase. A significant increase from T2 to T3 was noted only for the FFB group. Implant insertion torque was significantly higher in the FFB group. Insertion torque ≥32 N/cm was achieved in significantly more patients in the FFB group. CONCLUSION The use of FFB for sinus augmentation is a reliable option of graft material. The newly formed bone quality performance, evaluated by CBCT density, is as good as AB, allowing predictable initial implant stability and osseointegration. Unnecessary morbidity associated with AB harvesting is thus avoided.
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Affiliation(s)
- Liat Chaushu
- Attending, Department of Periodontology and Implant Dentistry, School of Dentistry, Tel Aviv University, Israel.
| | - Erick Ricardo Silva
- Attending, Department of Oral and Maxillofacial Surgery and Periodontology School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
| | - Vitor Ferreira Balan
- MSc Student in Oral and Maxillofacial Surgery - Dental School of University of Sao Paulo - Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
| | - Gavriel Chaushu
- Department of Oral & Maxillofacial Surgery, School of Dental Medicine, Tel Aviv University, Tel-Aviv, Department of Oral & Maxillofacial Surgery, Rabin Medical Center, Campus Beilinson, Petah Tiqwa, Israel.
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology. School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Younes F, Cosyn J, De Bruyckere T, Cleymaet R, Eghbali A. A 2-year prospective case series on volumetric changes, PROMs, and clinical outcomes following sinus floor elevation using deproteinized bovine bone mineral as filling material. Clin Implant Dent Relat Res 2019; 21:301-309. [PMID: 30740863 DOI: 10.1111/cid.12730] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A sinus floor augmentation may be indicated when a lack of hard tissue impedes implant placement. Although clinically successful, evidence supporting the long-term three-dimensional stability of the grafted volume is scarce. Second, evidence on the patient's acceptance of this type of treatment is limited. PURPOSE First is to evaluate the changes in graft volume after lateral wall sinus lifting based on superimposed cone beam computed tomography (CBCT) images and then to assess patient-reported outcome measures (PROMs) and clinical outcomes. MATERIALS AND METHODS Partially edentulous patients in need of a sinus lift and fixed reconstruction on at least two neighboring implants were selected for a prospective case series. Lateral wall sinus augmentation was performed using deproteinized bovine bone mineral (DBBM) as the only filling material. Volumetric changes were quantified on the basis of a preoperative CBCT and three postoperative CBCTs (at 2 weeks, 3 months, and 2 years). PROMs and clinical parameters were registered. RESULTS Twenty-two patients (7 males, 15 females; mean age 59 years) participated of which three patients dropped out during the follow up. Graft volumes amounted to 1418.26 mm3 at 2 weeks, 1201.21 mm3 at 3 months, and 1130.13 mm3 at 2 years postoperative pointing to a relative graft volume stability of 79.7%. Swelling was the leading symptom during the first week. A peak in visual analogue scale scores was observed for pain, swelling, and hematoma the day of surgery and 1 day postoperation with a statistically significant decline between days 3 and 7. Hemorrhage and nose bleeding occurred in 18.2% and 27.3% of the subjects, respectively. About 95.5% of the subjects would undergo the treatment again. All implants integrated successfully and demonstrated healthy clinical conditions. CONCLUSION Lateral wall sinus augmentation using DBBM as the only filling material is a viable treatment concept given limited graft resorption, good patients' tolerance, and clinical outcomes.
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Affiliation(s)
- Faris Younes
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Thomas De Bruyckere
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Robbert Cleymaet
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Aryan Eghbali
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
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Subantral Augmentation With Mineralized Cortical Bone Allograft Material: Clinical, Histological, and Histomorphometric Analyses and Graft Volume Assessments. IMPLANT DENT 2017; 25:353-60. [PMID: 26866847 DOI: 10.1097/id.0000000000000391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to clinically and histologically evaluate the effect of using mineralized cortical bone allograft in sinus lift augmentation and to 3-dimensionally quantify volumetric changes in maxillary sinuses augmented over a 2-year period. MATERIALS AND METHODS Eleven patients affected with less than 3 mm of residual ridge were enrolled in the study. After sinus grafting with a mineralized bone allograft, the site was covered with a collagen wound dressing. During implant placement 4 months later, a biopsy was obtained for histological and histomorphometry evaluations. Bone volume changes were also evaluated. RESULTS Biopsies showed mature cancellous bone with a predominantly lamellar structure. The well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Histomorphometry evaluations revealed a mean 43.76 ± 1.47% of bone marrow, 40.16 ± 1.35% of mineralized bone and 16.59 ± 0.55% of woven bone. The mean of residual particles was 0.47 ± 0.01%. Volumetric measurements showed a mean volume of grafted material 16.24 ± 1.55 cm at T0, 14.48 ± 1.48 cm at T1, and 13.06 ± 1.39 cm at T2. The mean volume retraction was 10.83% of the initial total volume at (T0-T1) and 9.8% at (T1-T2). CONCLUSIONS The clinical and histological results indicated that mineralized cortical bone allograft promoted de novo bone formation and can be used for sinus lift procedure.
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El Shazley N, Hamdy A, El-Eneen HA, El Backly RM, Saad MM, Essam W, Moussa H, El Tantawi M, Jain H, Marei MK. Bioglass in Alveolar Bone Regeneration in Orthodontic Patients: Randomized Controlled Clinical Trial. JDR Clin Trans Res 2016; 1:244-255. [PMID: 30931746 DOI: 10.1177/2380084416660672] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This study was designed as a split-mouth randomized controlled clinical trial to evaluate the effects of a novel bioactive glass scaffold-tailored amorphous multiporous (TAMP)-for the preservation of alveolar bone following tooth extraction in class II orthodontic patients. TAMP scaffolds were prepared and sterilized. Patients were screened for eligibility, and 6 patients accounting for 14 extraction sockets were included in this stage. Sockets were randomly allocated to either control (left empty) or test (grafted with TAMP scaffold particles). Follow-up was done after 1, 2, 4, 8, and 12 to 17 wk with digital periapical radiographs to evaluate changes in crestal bone height and bone mineral density (BMD), 3-dimensional volumetric analysis of impression casts, and histologic analysis of core biopsies. Furthermore, alveolar bone marrow mesenchymal stem cells were cultured from control and test sockets following biopsy retrieval to evaluate the ability of TAMP bioactive glass scaffolds to recruit host progenitor cells. Results showed that sockets grafted with TAMP bioactive glass scaffolds better preserved height after 3 mo where mesially 57.1% of test cases showed preservation of socket height, compared with 28.6% of control cases. Distally, this was 42.9% of test cases versus none of the control cases. Regarding BMD, the test sides had higher BMD in all 3 sections of the socket, with the greatest reduction in BMD found in the coronal third. Results were not statistically significant. Histologically, sockets grafted with TAMP bioactive glass scaffolds showed a distinct pattern of bone healing characterized by vertical trabeculae and large vascularized marrow spaces with sockets showing corticalization. Volumetric analysis showed a better preservation of socket contour with TAMP bioactive glass scaffolds. TAMP bioactive glass scaffolds appeared to enhance the recruitment of stem cells from the grafted sockets. In conclusion, TAMP scaffolds appear to better preserve alveolar bone following extraction and allow for a more active bone modeling and remodeling process( ClinicalTrials.gov identifier:NCT01878084). Knowledge Transfer statement: The results of this study set the stage for the recommended use of novel biomimetic scaffolds, such as the tailored amorphous multiporous bioactive glass for preservation of the socket following extraction. This can be valuable for patients and clinicians alike when deciding on long-term prosthetic alternatives that not only result in immediate bone preservation but will accommodate the dynamic nature of bone.
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Affiliation(s)
- N El Shazley
- 1 Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - A Hamdy
- 1 Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - H A El-Eneen
- 1 Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - R M El Backly
- 1 Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,3 Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - M M Saad
- 1 Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,4 Oral Biology Department, Faculty of Dentistry, Pharos University, Alexandria, Egypt
| | - W Essam
- 1 Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,5 Department of Pedodontics and Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - H Moussa
- 6 Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - M El Tantawi
- 7 Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - H Jain
- 8 Department of Materials Science and Engineering, Lehigh University, Bethlehem, Pennsylvania, USA
| | - M K Marei
- 1 Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,9 Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Yu H, Wang X, Qiu L. Outcomes of 6.5-mm Hydrophilic Implants and Long Implants Placed with Lateral Sinus Floor Elevation in the Atrophic Posterior Maxilla: A Prospective, Randomized Controlled Clinical Comparison. Clin Implant Dent Relat Res 2016; 19:111-122. [PMID: 27436543 DOI: 10.1111/cid.12439] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Very few controlled studies have compared short and long implants placed with appropriate sinus floor elevation techniques. PURPOSE To compare the 2-year outcomes of 6.5-mm hydrophilic implants placed with osteotome sinus floor elevation (OSFE) and standard implants placed with lateral sinus floor elevation in patients with a severely atrophic posterior maxilla. MATERIALS AND METHODS Thirty-eight patients with a residual bone height of 4-5 mm were randomized to receive one of the two above-mentioned treatments. Intra- and postoperative complications were recorded. The implant survival rate, peri-implant bone level, and periapical endosinus bone gain were assessed. RESULTS Of the 80 inserted implants, one in the long implant group failed because of abscess formation. The peri-implant bone level change (0.35 ± 0.60 mm vs 0.40 ± 0.71 mm) was not significantly different between the two groups. The endosinus bone gain was 2.94 ± 0.81 mm and 10.19 ± 0.95 mm in the short and long implant groups, respectively. No serious adverse events related to implant surgery were recorded. CONCLUSIONS The results suggest that the placement of 6.5-mm short implants with OSFE is an effective alternative for the rehabilitation of a severely atrophic posterior maxilla.
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Affiliation(s)
- Huajie Yu
- Prosthodontist, Restoration/Data analysis, 4th Dental Department, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xing Wang
- Professor, Critical revision of article, President of Chinese Stomatological Association, Beijing, China
| | - Lixin Qiu
- Professor, Surgery/Approval of article, Dean of 4th Dental Department, Peking University School and Hospital of Stomatology, Beijing, China
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Umanjec-Korac S, Parsa A, Darvishan Nikoozad A, Wismeijer D, Hassan B. Accuracy of cone beam computed tomography in following simulated autogenous graft resorption in maxillary sinus augmentation procedure: an ex vivo study. Dentomaxillofac Radiol 2016; 45:20160092. [PMID: 27225346 DOI: 10.1259/dmfr.20160092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES: Maxillary sinus augmentation is a well-documented procedure with long-term success in implant dentistry. Assessing graft volume changes over time is crucial, since resorption remains a major concern. CBCT is commonly employed to assess the quantity and quality of the available bone at the implant receptor site. However, its applicability in following graft volume changes is yet to be determined. The study aimed to assess CBCT accuracy in following simulated graft resorption ex vivo. METHODS: 4 differently sized autogenous bone blocks harvested from the zygomatic buttress were bilaterally placed in the maxillary sinus of 12 human cadavers. The Accuitomo (J Morita, Kyoto, Japan) CBCT system was employed to scan each one of the 4 grafts in each of the 12 cadavers using identical settings. Gold standard graft measurements were obtained using micro-CT. One independent observer assessed the volume of each graft on CBCT images twice. Intraobserver reliability was assessed using Cohen's kappa and one-sample t-test was used to compare CBCT with micro-CT volumetric measurements. RESULTS: The mean micro-CT graft volumes were 97.12 ± 1.4, 197.32 ± 3.4, 361.41 ± 4.2 and 1040.11 ± 3.2 mm3 for Grafts 1-4, respectively, and the mean CBCT volumes of the corresponding grafts were 115.39 ± 7.01, 205.97 ± 9.91, 404.05 ± 16.81 and 1138.04 ± 20.98 mm3. CBCT measurements were statistically significantly different from micro-CT measurements (p = 0.001). Intraobserver reliability was good (r = 0.78). CONCLUSIONS: In every case, CBCT overestimated the maxillary graft volume in comparison with micro-CT. However, the measurement differences were limited and might not influence clinical performance.
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Affiliation(s)
- Sanja Umanjec-Korac
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Azin Parsa
- 2 Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Aria Darvishan Nikoozad
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Daniel Wismeijer
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Bassam Hassan
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
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17
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Younes F, Eghbali A, De Troyer S, De Bruyckere T, Cleymaet R, Cosyn J. Marginal and apical bone stability after staged sinus floor augmentation using bone condensing implants with variable-thread design: a two-dimensional analysis. Int J Oral Maxillofac Surg 2016; 45:1135-41. [PMID: 27156066 DOI: 10.1016/j.ijom.2016.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 01/20/2016] [Accepted: 04/19/2016] [Indexed: 11/18/2022]
Abstract
Studies on the vertical stability of augmented bone after sinus lifting differ substantially. In addition, long healing periods are usually advocated prior to implant installation. The purpose of this case series study was to evaluate the changes in bone height after sinus lifting with a bovine-derived xenograft and to evaluate the clinical outcome of bone condensing implants installed after a short healing period. Patients treated during the years 2010-2013 were re-examined using peri-apical radiographs to evaluate the changes in augmented bone height (BH) and marginal bone loss (BL). Fifty-seven of 70 eligible subjects (28 male and 29 female, mean age 56 years) attended for reassessment. Data were available for 53 sinus lifts and 105 implants installed after a mean healing period of 4.6±1.5 months. Implant survival was 99% after a mean time in function of 19±9 months. Baseline BH, BH at implant placement, and final BH were on average 3.87±1.74mm, 13.75±2.12mm, and 13.11±2.12mm, respectively (P<0.001). Mean BL was 0.51±0.65mm. Only limited resorption is to be expected after sinus lifting in the short term. A bone condensing implant can be used in the early healing phase with successful outcomes in terms of implant survival and bone adaptation.
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Affiliation(s)
- F Younes
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - A Eghbali
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - S De Troyer
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - T De Bruyckere
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - R Cleymaet
- Department of Restorative Dentistry, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - J Cosyn
- Department of Periodontology and Oral Implantology, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Three-dimensional maxillary and mandibular regional superimposition using cone beam computed tomography: a validation study. Int J Oral Maxillofac Surg 2016; 45:662-9. [DOI: 10.1016/j.ijom.2015.12.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 10/27/2015] [Accepted: 12/08/2015] [Indexed: 11/21/2022]
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19
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Berberi A, Bouserhal L, Nader N, Assaf RB, Nassif NB, Bouserhal J, Salameh Z. Evaluation of Three-Dimensional Volumetric Changes After Sinus Floor Augmentation with Mineralized Cortical Bone Allograft. J Maxillofac Oral Surg 2015; 14:624-9. [PMID: 26225054 PMCID: PMC4511887 DOI: 10.1007/s12663-014-0736-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 12/04/2014] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of this retrospective study was to quantify three-dimensional (3D) volumetric bone changes over a two-year period in maxillary sinuses augmented with a mineralized cortical bone allograft material (MCBA) material. PATIENTS AND METHODS Eleven patients (6 males and 5 females) with mean of age of 51.6 (range: 46-61) years were treated to increase the vertical dimension of the alveolar crest by maxillary sinus floor augmentation procedure. Study data were collected from patient records and by analyzing preoperative radiographs and cone beam computed tomography (CBCT) scans taken within the first two weeks after maxillary sinus lift (T0), immediately before implant placement four months after grafting (T1), and after one year of implant loading (T2). All DICOM-formatted images were rendered into volumetric images using software that automatically calculated the volume of the grafted material in cubic centimeters. RESULTS Mean graft volume was 16.24 ± 1.54 cm(3) at T0, 14.48 ± 1.48 cm(3) at T1 and 13.06 ± 1.39 cm(3) at T2. Mean volume retraction resulted in 1.76 ± 0.34 cm(3) ΔV1 (T0-T1) and 1.42 ± 0.4 cm(3) ΔV2 (T1-T2) and was 10.83 % of the initial total volume at (T0-T1) and 9.8 % of the total volume (T1-T2). CONCLUSION The present retrospective investigation demonstrated a 20.63 % decrease in graft volume. Volumetric 3D assessment of CBCT scans with the selected software appeared to be a promising approach to quantifying long-term changes in the grafted area.
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Affiliation(s)
- Antoine Berberi
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
- />Oral Surgery Section, ENT Department, Sacre-Coeur Hospital, Lebanese University, Beirut, Lebanon
| | - Lea Bouserhal
- />Department of Orthodontics, Case Western Reserve University, Cleveland, OH USA
| | - Nabih Nader
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Rita Bou Assaf
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Nayla Bassil Nassif
- />Orthodontics Department, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Joseph Bouserhal
- />Orthodontics Department, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Ziad Salameh
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
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Barone A, Toti P, Quaranta A, Alfonsi F, Cucchi A, Calvo-Guirado JL, Negri B, Di Felice R, Covani U. Volumetric analysis of remodelling pattern after ridge preservation comparing use of two types of xenografts. A multicentre randomized clinical trial. Clin Oral Implants Res 2015; 27:e105-e115. [PMID: 25727443 DOI: 10.1111/clr.12572] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this randomized clinical trial was to analyse and compare the volumetric changes after ridge preservation procedures using two different biomaterials and to evaluate associations between outcome variables and pristine three-dimensional aspects of the ridges. MATERIALS AND METHODS Twenty-eight patients subjected to single-tooth alveolar ridge preservation were enrolled in the present multicentre, single-blind, prospective and randomized clinical trial. Fourteen sites were randomly allocated to each experimental group. The experimental sites were grafted with pre-hydrated collagenated cortico-cancellous porcine bone (coll group) or with a cortical porcine bone (cort group) and a collagen membrane; a secondary soft tissue healing was obtained for all experimental sites. Plaster casts were scanned (preoperative, at 1 and 3 months postoperative). Analysis of volumes and areas was performed, and all measured variables were statistically compared. RESULTS Intragroup analyses at 3 months revealed that when examining changes related to three-dimensional features of remodelling patterns (volume, surfaces, height and shape), the two biomaterials showed similar behaviours with a minor loss in volume and ridge surface. Intergroup analysis at 3-month survey revealed that volume resorption of the coll group (244 mm3 ) was significantly lower (P = 0.0140) than that of the cort group (349 mm3 ). The reduction for basal surface appeared significantly different between the two groups at 1-month survey only (P = 0.0137), while the final basal surface reduction was 4.9 and 12.2 mm2 for coll and cort group, respectively. The superior surface reduction was 40.8 mm2 for coll and 50.7 mm2 for cort group, with no significant difference between the two groups. CONCLUSION At the 3rd month analysis, coll group showed a significantly lower reduction of ridge volume and a significantly smaller shrinkage of the basal area when compared to the cort group; moreover, the coll group experienced a smaller superior surface shrinkage when compared to the cort group, even though no significance was evaluated.
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Affiliation(s)
- Antonio Barone
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy. .,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore (LU), Italy.
| | - Paolo Toti
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore (LU), Italy
| | - Alessandro Quaranta
- Department of Odontology and Specialized Clinical Sciences (DISCO), Marche Polytechnic University, Torrette di Ancona, Italy
| | - Fortunato Alfonsi
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore (LU), Italy
| | | | | | - Bruno Negri
- Department of Implantology, University of Murcia, Murcia, Spain
| | | | - Ugo Covani
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore (LU), Italy
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Physicochemical characteristics of bone substitutes used in oral surgery in comparison to autogenous bone. BIOMED RESEARCH INTERNATIONAL 2014; 2014:320790. [PMID: 25143936 PMCID: PMC4119630 DOI: 10.1155/2014/320790] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 06/08/2014] [Indexed: 11/17/2022]
Abstract
Bone substitutes used in oral surgery include allografts, xenografts, and synthetic materials that are frequently used to compensate bone loss or to reinforce repaired bone, but little is currently known about their physicochemical characteristics. The aim of this study was to evaluate a number of physical and chemical properties in a variety of granulated mineral-based biomaterials used in dentistry and to compare them with those of autogenous bone. Autogenous bone and eight commercial biomaterials of human, bovine, and synthetic origins were studied by high-resolution X-ray diffraction, atomic absorption spectrometry, and laser diffraction to determine their chemical composition, calcium release concentration, crystallinity, and granulation size. The highest calcium release concentration was 24. 94 mg/g for Puros and the lowest one was 2.83 mg/g for Ingenios β-TCP compared to 20.15 mg/g for natural bone. The range of particles sizes, in terms of median size D50, varied between 1.32 μm for BioOss and 902.41 μm for OsteoSponge, compared to 282.1 μm for natural bone. All samples displayed a similar hexagonal shape as bone, except Ingenios β-TCP, Macrobone, and OsteoSponge, which showed rhomboid and triclinic shapes, respectively. Commercial bone substitutes significantly differ in terms of calcium concentration, particle size, and crystallinity, which may affect their in vivo performance.
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